Genomics and your hospital: CEO perspectives

Three CEOs discuss the impact of genomics on patient care, and what hospital leaders can do to support it.

Watch: Hospital CEOs discuss genomic care.

What do hospital leaders think about genomics? Is it on their radar at all? How prepared are they for the changes it will bring to healthcare?

A panel of hospital CEOs explored these questions at The State of Genomic Care summit. Facilitator Angela Scaffidi led Adam Horsburgh from Alfred Health, Prof Eugine Yafele from Monash Health, and Rowena Clift from Western District Health Service in an animated and honest discussion on where they sit with genomics.

Balancing priorities

Ms Clift opened by describing the overall scarcity of medical services in her region. “The first available GP appointment is 12 weeks at the moment, where I am.” She saw genomics as an issue of equity, not wanting the people in her region to miss out on care they needed in the future. “That might take a level of early adoption, the further out we go,” she said.

Prof Yafele also spoke about balancing current challenges with future planning. “We are probably focused on what we need to get through today as opposed to how we build capability for delivering health tomorrow … But I also think there is the opportunity for us to start tailoring how we treat people to who they are.”

The problem with 'niche'

The CEOs acknowledged they have tended to see genomics as a niche specialty, although this perception is shifting over time.

Mr Horsburgh said that his understanding had evolved over the years he served on the Board of Melbourne Genomics. “Probably the first thing – which is known much more deeply by everyone else in this room – is the potential for genomics around advancing clinical care, individualised treatment plans, improve diagnostic capability.”

Prof Yafele agreed that perceptions needed to shift. “I think if we aren't giving it our attention, it will continue to be niche, right? So how do we make it less a specialist sport?”

Getting the attention of decision makers

The discussion shifted to how to align genomics with the big-picture issues facing the health system. “It’s about care closer to home. That’s a big reform idea for the department and the whole system at the moment,” said Mr Horsburgh.

Both Ms Clift and Prof Yafele believed that hospital leaders needed to understand the importance of good clinical governance for genomics.

“For me, there’s strong clinical governance that sits around this, but not to get in the way of innovation as well,” Ms Clift said. She went on to discuss the Genomics and Your Hospital toolkit developed by Melbourne Genomics. “I’d like to see how we can use things like these toolkits to set standardised but localised types of care.”

Genomics within Health Service Networks

Victoria’s health services are now forming networks, with formalised relationships between hospitals within specific regions. “There’s an opportunity, I think, to take the coordination of genomic care to the next level, starting with the networks,” said Mr Horsburgh.

Ms Clift agreed. “How do we set a standard of care no matter where you are, but how do we support that local care too? (…) I don’t think that’s impossible. But I do think we have to rethink workforce and what it means in rural and regional Victoria.”

Prof Yafele had the last word, returning to the challenge of prioritisation. “We can't have our focus just on today. However challenging it is, we need to be spending some of our time, energy, and effort in thinking how we can create the capability to look after people differently and better tomorrow. And genomic care is the bedrock of this.”